In traditional Chinese medicine, every organ has a physical as well as a mental or emotional function within the human body – and our ability to be brave and decisive is dependent on the energy of our gallbladder. Emotionally, the gallbladder governs daring and is responsible for our decision making, judgment, and courage. As stated in the Su Wen (Chapter 8), “the gallbladder is responsible for what is exact and just – determination and decision stem from it.” This is more than just making good choices: it’s about being able to connect with the guiding principles we want to live by, and use these principles to make life decisions that serve us well. Likewise, people who are determined and unafraid of change are said to have strong gallbladder energy. They are courageous and bold – even audacious at times. These are often the people who stand out as having a strong point of view and feel comfortable speaking their mind. Beyond their confident words and opinions, they’re also great at planning and executing their decisions. Notably, the word for “daring” in Chinese is da dan – translated as “big gall” – an idiom which parallels the English phrase “a lot of gall.” As an old Chinese adage says: “The gallbladder is daring, the heart is careful.”

Alternately, when gallbladder energy is weak, blocked or deficient, a person may feel nervous, anxious or timid. They may lack the courage or initiative to move forward in life or have trouble making decisions that help them reach their goals. They may find it difficult to stand up for themselves or assert their feelings. This is often accompanied by a poor self-image and timid personality. It is not uncommon for them to be easily discouraged by even the slightest adversity or unexpected set-back. A person plagued by deficient gallbladder energy may feel stuck in life with no purpose or direction forward.

Being easily startled and suffering from a general feeling of fear (especially in regards to decision-making) are hallmarks of gallbladder insufficiency. This often relates to feeling fearful or panicked about our choices and their consequences. The gallbladder usually commands our short-term decisions, but with a clear understanding of the impact that our immediate decisions will have upon our long-term plans. When there is imbalance, an individual can become overly concerned with the smallest details and lose sight of the big picture. When the gallbladder is deficient, indecision, procrastination and hesitation prevail.

Not surprisingly, the gallbladder is an emotionally charged organ that can easily be affected by events and our environment. Our ability to “bounce back” after adversity or a sudden physical/emotional shock is the sign of a strong gallbladder. When the gallbladder is well-balanced, it provides us with an anchor and solid foundation. Decisions made with a strong gallbladder are clear and decisive – our thoughts are focused and our actions are determined. A healthy gallbladder allows us to maintain sound judgment when confronted with difficult or adverse conditions.

Interestingly, when the gallbladder is in excess (also a pathological condition according to Chinese medicine) anger and impulsiveness will be manifest. Other characteristics of excess gallbladder energy include holding on to resentment and making rash decisions.

A constitutional or pathological lack of courage or decisiveness in life typically defines a pattern referred to as “gallbladder vacuity” in Chinese medicine (or a mixed pattern that often includes heart deficiency as well). This can occur when someone who is often insightful and confident in their decision-making becomes overwhelmed from relentless challenges, or overtired by chronic stress, and now finds it difficult to find their way forward.

Mental and emotional signs of gallbladder imbalance / deficiency:

• Lack of confidence, courage or initiative

• Poor self-image

• Lack of assertiveness and an inability to express one’s opinions

• Indecisiveness or poor decision-making

• Tendency to prevaricate or procrastinate

• Failure to live up to great promise or choose the right way forward

• Easily saddened, upset or startled

• Overwhelmed by daily stress

• Anxiety or depression

• Fearful attitude toward the new or unknown

Physical signs of gallbladder imbalance / deficiency:

• Dizziness that may be worse upon effort, movement or rising

• Impaired or blurred vision

• Sighing (an audible sound upon inhaling or exhaling)

• Rib-side pain

• Nausea and vomiting, sometimes with a bitter taste in the mouth

• Panic attacks with shallow breathing

• Insomnia (waking very early in the morning / unable to return to sleep)

• Vivid dreams

• One-sided or asymmetrical pain (the gallbladder governs the body’s right side)

• Frequent headaches – in Chinese medicine, the common tension headache is often attributed to obstructions along the gallbladder channel, whose pathway runs up and over the shoulders and the back of the neck, to the top of the head and forehead – explaining why such headaches are usually accompanied by neck and shoulder tension.

In Chinese medicine, it is impossible to talk about the gallbladder without talking about the liver. Indeed, these two organs are so closely related that it can be difficult to separate their functions and disharmonies. The liver, known as “the general,” creates our thoughts and ideas, – planning and strategizing. The gallbladder, “the general’s advisor,” implements the liver’s plans and oversees their execution. Gallbladder disharmony will affect the liver, and vice versa.

In addition to their close physical proximity within the body, Chinese medical theory views the liver and gallbladder as paired organs that share the same Wood element aspects. The liver is considered the “Yin” organ – and is often associated with anger and the drive to move forward – like a general commanding an army. The gallbladder, on the other hand, is the “Yang” organ of the pair, like a soldier in the thick of battle – the one who must show the most courage and make the actual decisions.

Yin organs are defined as solid organs that produce, transform and regulate fundamental substances such as Qi, Blood and body fluids. In addition to the liver, Yin organs include the spleen, heart, lungs and kidneys. Alternately, Yang organs are said to be hollow or empty, and are mainly responsible for digesting and transmitting nutrients to the rest of the body. Besides the gallbladder, other Yang organs in the body include the stomach, small and large intestine, and bladder. The liver produces bile, which the gallbladder stores and eventually secretes into the small intestine to assist in digestion (bile is needed to metabolize and digest the fats in our diet, similar to the way soap acts to break down greasy substances). The Yin-Yang relationship between the liver and gallbladder lies in the fact that together, they govern what the Chinese call “dredging and dispersing”.

The gallbladder's job of storing and emptying the bile is dependent on the liver’s ability to regulate the smooth flow of Qi. When the liver Qi flows smoothly and easily, bile is produced and excreted regularly, ensuring optimal digestion. When the liver stagnates, bile production is impaired, resulting in digestive disharmonies such as acid reflux, abdominal distention and bloating, belching, bad breath, flatulence, indigestion, constipation and/or vomiting. If the relationship between the liver and gallbladder is impaired, digestion will suffer. Ultimately. a healthy gallbladder requires a healthy liver.

Just as the gallbladder regulates the release of bile to cut through the fats we’ve eaten to make them more digestible, so too does it help us cut through the ambiguity and obscurity we face each day to help bring clarity and decisiveness to our life.

In addition to the liver, the gallbladder has close relationships with all of our other organs, which are said to follow the gallbladder’s lead. The Su Wen states (Chapter 9) that “the eleven depots (zang-fu organs) receive decisions from the gallbladder.” If gallbladder Qi is correct and righteous at the start of our decision making, the other organs follow its directional movement forward. Alternately, if gallbladder Qi is weak, blocked or scattered, this will eventually produce a similar domino effect impacting the rest of our organs and their myriad functions.

Second perhaps only to its connection with the liver, the relationship between the gallbladder and heart is also quite close and significant. The gallbladder’s decisiveness helps the heart to control the mind, guiding our Shen (spirit) and providing direction for it. The Shen resides in the blood – during the day, the heart is where most of the blood activity resides, but at night, the blood returns to the liver and the Hun. The gallbladder helps lead the Shen in this process.

There are several different ways of looking at the connection between the heart and gallbladder in Chinese medicine. From a five element, “mother-son” perspective, the gallbladder (wood) supports heart (fire) – providing the energy it needs to burn bright. From a meridian perspective, the gallbladder’s divergent channel travels to the heart. The heart and gallbladder are also opposites on the Horary body-clock, with gallbladder being the weakest at 11am-1pm during heart time, and vice versa. The two organs also share common diagnostic patterns like heart-gallbladder Qi deficiency (as well as an excess condition referred to as heart-gallbladder phlegm-heat). Along with these patterns are shared pathological symptoms such as bitter taste, which is often associated with heart fire, but is also a sign of a gallbladder disorder (and usually an indicator of a mixed gallbladder-heart pattern). All these principles and theories can be used during treatment, to potentially supplement the heart as well as treat gallbladder deficiency (presenting with timidity and fear,) or treat the gallbladder to address Shen issues (sometimes manifesting as “phlegm misting the orifices”).

In addition to the liver and the heart, strong, balanced gallbladder energy is crucial for the kidneys, which control our will and determination, according to Chinese medicine. Indeed, it is a decisive gallbladder, with its initiative and drive, that helps turn determination into decisive action. And while the kidneys produce marrow and rule the bones, the Ling Shu (Chapter 10) states: “In cases of bone disease, we must needle points on the gallbladder.”

The gallbladder also helps with muscular strength and vitality. This is seen by the gallbladder’s ability to work with the liver (and lymphatic system) to clear toxins from the body. These toxins are physiological by-products of the sinews and organs that build up in the body throughout the day and are deposited in the blood. At night, the gallbladder pulls blood away from the sinews and into the liver. If the gallbladder is not relaxed by 11pm, it cannot perform this function efficiently and the liver will be unable to properly detoxify and cleanse the blood during liver time (between 1:00am- 3:00am). If we don’t sleep well, or long enough, muscle aches, pain, and fatigue set in, and we will wake up feeling stiff and sore. It’s not surprising that the gallbladder is referred to as the “central clearing department” of the body in Chinese medicine.

A particularly extraordinary organ

While the gallbladder is categorized as a Yang (fu) organ, it also has Yin (zang) characteristics. Because of this unusual duality, the Chinese refer to the gallbladder as an extraordinary or “curious” organ. (Other extraordinary or “curious” organs in our body include the brain, uterus, bone, vessels and marrow). As mentioned earlier, being hollow and bowel-like, it resembles other Yang (fu) organs. But unlike other fu, the gallbladder is the only Yang organ that does not transport impure substances, nor is it ever in direct contact with food, waste or the exterior. Functionally, the gallbladder resembles a Yin (zang) organ because it stores pure fluid bile. While this may seem like an esoteric point, it is, in fact, a remarkable exception to how most of our organs behave.

Emotionally, the gallbladder acts as a “pivot” — a turning point where we must choose between following old patterns of behavior or embracing new beginnings. As a pivot, the gallbladder represents the hesitation that often characterizes our decisions between courage and fear, action and inaction, fight or flight. The Su Wen, (Chapter 9) discusses the gallbladder’s back-and-forth nature – or shaoyang – as a kind of turning place (alternating between heat and cold) or hinge (between the exterior of the body and the interior). And as mentioned above, the gallbladder alternates between zang and fu, and between Yin and Yang. Even the gallbladder channel’s famous zig-zag “geography” over the body reflects the inherent dynamic of decision making and discernment – should I follow this path or that path?

Acupuncture can help bring gallbladder energy back into balance by needling certain points along the channel, as well as other points chosen for their effect on the Shen (spirit) or for their role in strengthening the Water element, mother of Wood. Moxa is another great way to counter gallbladder deficiency – it warms and strengthens Yang energy to eventually help fortify courage. Applying moxabustion to qiu xu (GB-40), the source point of the gallbladder, is a very effective way to help tonify the gallbladder and boost its energy. This acupuncture point is located on the lateral side of the ankle and has a good effect to treat the mental aspect of the gallbladder.

In the 1930’s, Dr. Edward Bach determined through his research that the essence of the flower scleranthus could also help balance that negative emotional state characterized by indecisiveness, nervousness and fluctuating moodiness. I recommend applying scleranthus to ri yue (GB-24) – the front mu of the gallbladder where the Qi of the organ concentrates – as one form of self-care patients can take to help improve confidence in their decision-making abilities.

Ways to be kinder to your gallbladder

1. Avoid greasy, fatty, spicy food

Since the gallbladder is responsible for releasing bile to break down fats, a diet high in rich, fatty food will harm the gallbladder. Such foods clog the gallbladder (with a risk of gall stones), subjecting it to additional strain and overwork. Alternately, foods that benefit the gallbladder include: apples, barley, green leafy vegetables and peppermint tea. Garlic, onions and any of the cruciferous vegetables (kale, broccoli and cauliflower) all provide crucial, sulfur-rich nutrients that are necessary in the digestive process.

2. Drink a cup of warm lemon water every morning

Lemon helps ease the many jobs of the gallbladder, including increasing urination, which releases toxins faster. It also encourages the gallbladder to produce bile, one of the key acids used in digestion.

3. Express yourself

Stress and repressed anger are two of the main drains on gallbladder energy, leading to weakness and deficiency. Blocking or repressing our emotions – especially those associated with intense frustration, resentment or anger – can cause the flow of energy and blood to stagnate with the body, leading to an imbalance in liver-gallbladder energy. The liver-gallbladder is the most emotionally sensitive organ-pair and their weakness is often connected to emotional imbalance. That’s why it’s crucial to find healthy ways to relieve stress daily, as well as express our anger.

4. Use coconut oil

Coconut oil is great if you’re experiencing blockages in gallbladder or liver Qi since it does not need to be digested or emulsified by either organ. Unrefined coconut oil is easy on the gallbladder because it contains mostly short- and medium-chained fatty acids which do not require pancreatic enzymes or bile salts to digest.

5. Get to bed by 11:00pm

The gallbladder is most active – and at the height of its energetic powers – between the hours of 11:00 pm and 1:00 am – perhaps the reason why so many fights break out during these hours of the night! It’s also recommended to avoid alcohol or rich food between these hours and be in bed no later than 1:00am. This is followed by the liver meridian, which is most active between 1:00 a.m. and 3:00 a.m. Consistently waking during these hours is an indication that the gallbladder or liver is out of balance, often due to unhealthy eating, toxic overload, repressed emotions or stress.

6. Move your body every day to prevent stagnation

Yoga stimulates, regulates and enhances liver-gallbladder function through its combination of physical postures, breath techniques and meditation. Likewise, the practice of slow, deep breathing helps regulate the flow of Qi and calms the mind. Consider pairing the simple mental/emotional mantra to your breathing: inhaling kindness, generosity, forgiveness while exhaling anger, frustration and resentment.

7. Use natural skincare products

The average woman puts between 250 – 500 chemicals on her body every day. All of these ingredients compromise the lymph and liver. Likewise, prescription drugs, antacids, and OTC anti-inflammatory pain medications put excessive strain on the liver and gallbladder which are responsible for detoxifying chemicals and drugs in our body.

While the gallbladder is responsible for decision making and planning, on a deeper emotional level this tiny and often overlooked organ governs our passion for life, inspiration, action and assertiveness. When we feel timid or uninspired, have trouble following through on our promises, or find it difficult to be assertive, it is likely that we have an imbalance with our gallbladder.

Together with the liver, this Yin-Yang organ pair plays a critical role in our ability to get things done in life: the liver allows us to plan and anticipate, while the gallbladder enables us to be decisive and take action. While the liver influences our ability to find a sense of direction in life, it is the gallbladder that provides us with the courage and conviction we need to carry out our dreams. Together, strong liver and gallbladder energy keeps us confidently moving ahead in life – helping us decide on a course in life and then keeping us on it. When the liver and gallbladder are in balance, we are focused and decisive about our purpose in on earth and the path forward.